Neonatal Acne (Baby Acne): Symptoms, Causes, and Treatment

Ok, 3 weeks after birth. We got this!…yellowing of my baby’s skin (jaundice) is going away, weird red ant-bite-looking things (erythema toxicum) are no longer all over her body, and she is finally sleeping just a tad better.

Now what in the world are these new red bumps on the baby’s face? Your little one most likely has neonatal acne. Weren’t they supposed to experience acne in their teens? NO! Babies can experience acne, which is often referred to as baby acne. In this blog, we’ll help you understand what neonatal acne is, its symptoms, causes, and how to get rid of it.

What is Neonatal Acne?

Neonatal acne is a skin condition that causes red, tiny bumps on a newborn’s face. The medical terms for this condition are “neonatal cephalic pustulosis, acne neonatorum, and acne infantum.”

What a mouthful. It is no wonder pediatricians still just call this benign, temporary condition neonatal acne or baby acne. “According to the American Academy of Dermatology, about 20% of newborns experience it, but in my pediatric experience, I would say it happens much more frequently. It usually appears before the baby is 5 weeks old and is most common in babies of 4 weeks of age,” says Dr. Eddie.

If you are still wondering, what is baby acne? It looks quite similar to the pimples and breakouts of adult acne. Red bumps and what look like whiteheads (pustules) usually appear on the face; however, they can affect other parts of the body as well.

In most cases, it is not harmful to the baby and usually clears up on its own in a few weeks or months without causing scars. However, if you suspect that your baby is experiencing severe baby acne or is irritated by it, it is best to consult a pediatrician.

Neonatal Acne Symptoms

Most people think that newborn acne usually only affects the face; however, the truth is, according to the Cleveland Clinic, those tiny white pimples can also appear on the:

• Cheeks
• Neck
• Forehead
• Chin
• Scalp
• Nose
• Chest 
• Back 

And if you are still wondering what baby acne looks like, it looks similar to the acne that we experience as adults. It appears as tiny white or red bumps and pustules. Neonatal acne starts as tiny dots on the baby’s skin that later turn into raised bumps with redness around them.

Sometimes, these bumps are filled with liquid, giving them the iconic pimple look. However, it does not have any symptoms of blackheads (open comedones).

Here are some of the most common symptoms that may help you distinguish it from other similar skin issues:

• Clogged pores
• Small bumps 
• Red Papules
• White Pustules
• Redness around the pimples 
• Liquid-filled bumps

The redness around the bumps and pimples may vary depending on the baby’s skin tone. It may appear as red or pink in babies with lighter skin tones and purple in darker skin tones.

Learn more about Neonatal Acne from Dr. Eddie Valenzuela

• Baby Acne or Rash

What Causes Baby Acne?

The experts are not sure about what exactly might be causing pimples in newborns. However, some of the common baby acne causes are:

Maternal Hormones

In teenage acne, hormones are usually to blame. When babies experience acne, according to the Mayo Clinic, it’s mom’s hormones that can be blamed. The hormones transferred to the baby’s body before birth can trigger their oil glands to produce more sebum. This sebum may clog the pores and cause pimples and bumps on newborn face.

Malassezia Yeast

It is also hypothesized that neonatal cephalic pustulosis may be associated with Malassezia yeast, which is a type of fungus that normally lives on everyone from newborns to adults. However, sometimes its overproduction can trigger an inflammatory response on the skin that leads to pimples, breakouts, and acne on newborns.

It just so happens that the same yeast (fungus) is also the likely cause of cradle cap in babies, seborrheic dermatitis, and dandruff in adults.

Sensitive skin

Babies have delicate and sensitive skin; their pores are not fully developed, which makes it easier for dirt, drool, sebum, or anything left on the skin to clog the pores. As a result, acne and pimples appear on the baby’s face.

Diagnosing Baby Acne

While these symptoms may help you diagnose your baby’s acne, sometimes it can be confusing because many other skin conditions, like milia and eczema, can look quite similar to it.

So if you are unsure about anything, consult a dermatologist or your child’s pediatrician; they will accurately diagnose the condition and provide you with the best treatment plan. To diagnose neonatal acne, the doctor will usually physically examine the symptoms, and it does not require any specific test.

However, if the doctor suspects that the bumps and pimples are caused by some other condition or allergies, then they may perform a patch test or skin biopsy.

Neonatal Acne Treatment

Baby acne, in most cases, does not require any special treatment and usually disappears on its own. However, proper care and attention given to the skin can help resolve it much faster. Here are a few things that are best for baby acne:

Gentle Cleansing

Keep your baby’s skin clean with a baby cleanser every night. Make sure to use one that is specially formulated for your baby’s sensitive skin. Since Malassezia yeast contributes to neonatal acne, using a gentle cleanser that can reduce the activity of Malassezia yeast on the skin and help soothe baby acne even faster, in days potentially instead of weeks. Pyrithione zinc is a clinically proven active ingredient that helps control the activity of Malassezia yeast on the skin. It is found in Dr. Eddie’s Happy Cappy Medicated Shampoo, Face, and Body Wash. It is a cradle cap shampoo that can be used as a face wash for baby acne and fungal acne. And the best part is it is specially formulated for baby’s delicate skin.

So give your baby the gentle care they deserve with Happy Cappy today. 

Avoid Harsh Products

The best way to treat acne in babies is to keep it as far away from medications as possible. Especially the acne creams, face wash, and cleansers used by adults. Adult acne products contain harsh chemicals.

These chemicals can further irritate a baby’s delicate skin and lead to other skin issues like dry skin, flaky skin, and even trigger eczema. Also make sure the baby products you are using are also fragrance-free, sulfate-free, paraben-free, dye-free, and alcohol-free to prevent your baby’s condition from getting worse. 

Don’t Pick or Squeeze

Squeezing or picking the pimples on the baby’s skin will only make the condition worse. Bacteria from our hands can also cause other skin infections. So it is best to leave the pimples and breakouts alone. Just wash them, pat them dry, and that’s all.

Topical Medications 

Topical agents are not commonly prescribed for neonatal acne. However, in severe cases or when acne first appears after the age of 2 months (it is possibly “infantile acne” and should be evaluated by a pediatric dermatologist), they may prescribe the use of topical acne medications. 

How Long Does Newborn Acne Last?

Neonatal acne usually clears up within a few weeks or months. If a pediatrician has suggested the use of a neonatal acne cleanser, then it may resolve even faster.

A good thing about baby acne is it does not leave any scars. But if you suspect that your baby’s acne is not clearing up in a few weeks or months or is getting worse, it is best to consult a doctor. 

Stages of Baby Acne Healing

Baby acne can either appear suddenly or start developing slowly. It starts as small bumps on the skin that take the shape of pimples. But how to figure out if it’s healing? We have got your answer.

Once the acne on the baby’s skin starts to heal, the first thing that happens is the inflammation disappears. Then the redness around the pimples reduces. And finally the size of the pimples slowly starts reducing, and after a week or so they disappear. Leaving your baby’s skin soft, clean, and blemish-free. 

When to Consult a Pediatrician?

So when should you talk to a doctor for your baby’s acne? If the acne does not get better after 2 months of age or you notice any signs of it getting worse even after proper cleansing and care, then it is best to consult a doctor. 

If you notice any of the following, consult your baby’s pediatrician, as they may be experiencing something else in addition to the acne breakout.

• Fever
• Fussy and irritated baby
• Skin blisters
• Peeling skin
• Skin infection
• The baby is not feeding well.

Early diagnosis of the condition can help ensure that your baby gets the right treatment or care on time, especially if it’s something beyond neonatal acne. 

Neonatal Acne and Similar Skin Conditions

Neonatal and Infantile Acne

Many people consider infantile acne, neonatal acne, and baby acne to be the same. But the truth is, neonatal or baby acne is a little different from infantile acne. Baby acne usually appears in the first few weeks of your baby’s life, mostly before 6 weeks, and disappears within a few weeks.

On the other hand, infantile acne appears after 2 months of age and may take a long time to resolve. Sometimes it may persist until the baby turns 2 years old.

Here are a few key differences between baby acne vs infantile acne to help you identify them.

	Neonatal Acne	Infantile Acne
Age of onset	2 to 6 weeks old	After 2 months
Blackheads	No	Yes
Resolves	Within a few weeks or before the baby turns 2 months old	Usually lasts for months, sometimes until the baby turns 1 or 2 years old
Scarring	Usually no	Possible, especially if left untreated
Hormones associated	Maternal hormones	Baby’s own hormones
Treatment	Usually resolves on its own with gentle cleansing and care	May require medical treatment and topical medications

Neonatal Acne Vs Milia

Parents often confuse neonatal acne with another common skin condition known as Milia or milk spots, that causes small bumps on a baby’s face. The bumps are usually white in color. 

The difference between both conditions is that milia causes cysts that develop under the skin and appear as tiny bumps on the skin; they are not red and are usually smaller than acne bumps.  

While acne mostly develops due to clogged pores on the skin and causes small red bumps on the skin that may appear as pustules and papules. Inflammation that we see in baby acne is not a symptom of milia.

Here are a few key differences to help you distinguish them.

	Neonatal Acne	Milia
Causes	Clogged pores, maternal hormones, and malassezia yeast	Trapped skin cells under the skin
Inflammation	Yes	No
Appearance	Red or white pimples	Small pearly-white bumps
Location	Face, chest, neck, and back	Cheeks, nose, and around eyes

Erythema Toxicum vs Neonatal Acne​

Another common skin condition experienced by newborns is erythema toxicum neonatorum, or ETN. Parents often confuse both the conditions because they cause redness on the skin. However, the two conditions are quite different.

Erythema appears within a few days after birth and usually appears as red patches with a small white or yellow center. On the other hand, baby acne appears between the ages of 2 and 6 weeks and usually causes white pimples with redness around them.

Here are some differences between the conditions to help you identify them.

	Neonatal Acne	Erythema Toxicum
Onset	2-6 weeks	2-5 days after birth
Duration	A few weeks or a month	A few days, faster than neonatal acne
Appearance	Red or white pimples	Red blotches with yellow or white center

The good thing is that both the skin conditions are harmless and usually resolve on their own without any medical treatment. 

Baby Acne or Eczema

Eczema, also known as atopic dermatitis, and baby acne are two very common skin conditions in babies. These conditions are often confused with each other because of their similar symptoms, such as redness, rashes, and small bumps on the skin.

However, both conditions are totally different and require different treatments. Acne mostly appears within the first 6 weeks of a baby’s life, and eczema starts developing after 6 months of age. Baby acne is a temporary condition that will resolve in a few weeks, but eczema is a chronic condition. This means that it may resolve on its own, or it may persist in the form of eczema flare-ups for a long time.

Here are some common differences between baby acne and eczema.

	Neonatal Acne	Eczema
Onset	2-6 weeks of age	Usually after 2 months
Causes	Maternal hormones, malassezia yeast, and clogged pores	Genetics, skin barrier dysfunction, and environmental triggers
Appearance	Red and white pimples	Dry, red, itchy, flaky patches and pus-filled bumps
Itching	No	Yes
Chronic	No, clears up after a few weeks	Yes, it may appear again as a flare-up

If you notice that your baby’s skin is becoming dry, flaky, or itchy or has red patches on it, then there are chances they may be experiencing eczema. To be sure, it is a great idea to consult your baby’s pediatrician.

Mild cases of baby eczema can be easily managed at home by following a proper eczema skincare routine that includes:

• Keeping the skin clean with an eczema shampoo and body wash at least once daily.
• Moisturizing the skin with baby eczema cream at least twice daily.

Learn more about the difference between baby acne vs eczema in detail in this blog.

Can Kisses Cause Baby Acne?

If you are not kissing your baby and are scared that it will cause acne on their face, please don’t be. Kisses are not related to causing acne on a baby’s face. It is mostly the hormones in the baby’s body.

However, excessive kissing can result in irritated skin and red rashes. Babies have sensitive skin, and their natural barrier is still developing, which makes it difficult for the skin to protect itself against the bacteria and viruses transferred from kissing.

Key Takeaways

• Neonatal acne, or baby acne, is very common in newborns.
• Baby acne typically appears at 2 to 4 weeks of age.
• Baby acne is not harmful or contagious and usually disappears on its own after 4 to 6 weeks.

The best neonatal acne treatment is to keep the baby’s skin clean with a gentle baby face wash containing pyrithione zinc and not squeeze the pimples.

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